title: Idiopathic acute transverse myelitis: outcome and conversion to multiple sclerosis in a large series.
abstract: BACKGROUND
  In 2002, the Transverse Myelitis Consortium Working Group (TMCWG) proposed the diagnostic criteria for idiopathic acute transverse myelitis (IATM) to delimit and unify this group of patients. This study aimed to describe the conversion rate to multiple sclerosis (MS) and variables associated with conversion, and to analyze functional outcome and prognostic factors associated with functional recovery in patients who fulfilled the current TMCWG criteria for definite and possible IATM.
  
  
  METHODS
  Eighty-seven patients diagnosed with IATM between 1989 and 2011 were retrospectively reviewed. Two patients with positive neuromyelitis optica IgG serum antibodies were excluded. Epidemiological, clinical, laboratory, magnetic resonance imaging (MRI) data and outcome of 85 patients were analyzed.
  
  
  RESULTS
  Eleven (13%) patients converted to MS after a median follow-up of 2.9 years (interquartile range 1.0-4.8). Early-age onset of symptoms was related to conversion to MS. Only 9.4% of patients with IATM were unable to walk unassisted at the end of follow-up. Urinary sphincter dysfunction (odds ratio [OR] 3.37, 95% confidence interval [CI] 1.04-10.92) and longitudinally extensive transverse myelitis (LETM) on MRI (OR 12.34, 95% CI 3.38-45.00) were associated with a poorer outcome (Rankin ≥ 2).
  
  
  CONCLUSIONS
  At least 13% of patients who fulfill the TMCWG criteria for definite and possible IATM will convert to MS. Functional recovery in IATM is poorer in patients with urinary sphincter dysfunction at admission or LETM on MRI.
authors.affiliation: Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge - IDIBELL, Feixa Llarga s/n L'Hospitalet de Llobregat, Barcelona 08907, Spain. acobo@bellvitgehospital.cat.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Cobo Calvo
authors.forename: M Alba
authors.initials: MA
authors.lastname: Mañé Martínez
authors.forename: Agustí
authors.initials: A
authors.lastname: Alentorn-Palau
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruna Escuer
authors.forename: Lucía
authors.initials: L
authors.lastname: Romero Pinel
authors.forename: Sergio
authors.initials: S
authors.lastname: Martínez-Yélamos
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology*; D009188:Myelitis, Transverse / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D009471:Neuromyelitis Optica / Q000097:blood; D043025:Oligoclonal Bands / Q000097:blood / Q000134:cerebrospinal fluid; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D001323:Autoantibodies; D043025:Oligoclonal Bands